Northumberland Health Coalition Long-Term Care
At a scheduled press conference several issues were identified by the participating panel based on the Situation Critical Report produced by the Ontario Health Coalition.
Ontario’s long-term care homes have a rate of homicide that is 7 times higher than that of the largest cities in the country. It is higher than virtually anywhere else in our society. And it is unacceptable.
We are pointing the spotlight to this issue because it reveals the extreme end of a spectrum of violence that has escalated in Ontario’s long-term care homes to a point that crosses all moral boundaries and should be considered intolerable.
The twin issues of inadequate care and violence in long-term care homes is one of the top issues that we hear about from families, residents and care workers.
Our research uses the government’s own statistics and those of the long-term home operators themselves to look at what is causing this. This is what we found:
Access to care is poor:
– There are nearly 80,000 residents in Ontario’s long-term care homes, and more than 33,000 Ontarians waiting for a space.
– Waitlists are larger than an entire small town, In fact, Ontario ranks second last in the number of long-term care beds per capita.
But once people can get into long-term care homes, the actual levels of care are a major problem also:
– Levels of care are too low to meet basic safety requirements and our research shows that they have actually been declining.
– Acuity (heaviness and complexity) of residents has soared as Ontario governments have cut hospital beds to the lowest rates in the Canada and among developed nations. Almost no country and no other province has cut hospital beds to such an extreme as Ontario.
– As a result heavier care patients are offloaded from hospitals into long-term care. But care levels are not the same. For example, we found that fully ½ of Ontario’s chronic care hospital beds have been closed and the acuity of residents now in long-term care matches chronic care hospital level. But the funding of long-term care is 1/3 of the rate. The bottom line? Patients have been moved out to reduce cost at the expense of their health and safety.
– There is no question, today’s long-term care homes are the chronic care and psychogeriatric care hospitals of yesteryear but with many fewer resources.
– We looked at every measure of acuity of residents – and we found that the complexity of residents and their care needs have increased year after year.
– We looked at the actual hands-on care levels and found that not only have care levels not kept pace with the increasing care needs of the residents, they have actually declined over the last decade, leaving heavier-care residents with less actual care.
– For families who can afford it, they have to spend tens of thousands of dollars hiring in extra care. For those who can’t afford it, they suffer with inadequate care.
– For everyone, it means escalating violence.
Violence in long-term care:
– Investigative reports show that violence has increased as the complexity and care needs of the residents has risen and as actual care levels and staffing have declined.
– In the extreme, we can see that the number of homicides that are resident-on-resident homicides, is shocking.
– The Ontario Coroner reports that there have been 27 homicides over the last 5 years in Ontario’s LTC facilities.
– In fact, the homicide rate in long-term care in Ontario is more than four times that of Toronto! When compared to a city of almost 80,000 people (which is the number of people living in ltc in Ontario) the homicide rate in long-term care is up to 8 time higher.
Conclusion and recommendations:
We have included a number of recommendations in the report to resolve the critical situation in Ontario’s long-term care including instituting a required and enforced minimum care standard of 4 hours of care per resident per day to ensure that funding goes to improving actual care for residents; a stop to hospital offloading and cuts; and improved training and behavioural supports in all Ontario LTC homes.
The Local Picture
Using the Central East LHIN Numbers note the following waitlist and days people are waiting
Basic accommodation
Long stay beds # of patients on waitlist Wait time to placement (days)
Extendicare Cobourg Long stay beds 69/# of patients on waitlist 353/Wait time to placement (days) 1585
Extendicare Port Hope Long stay beds 128/# of patients on waitlist 205/Wait time to placement (days) 1020
Golden Plough Lodge Long stay beds 151/# of patients on waitlist 159/Wait time to placement (days) 512
Hope Street Terrace Port Hope Long stay beds 95/# of patients on waitlist 11/Wait time to placement (days) 355
Regency Manor Nursing Home Long stay beds 56/# of patients on waitlist 19/Wait time to placement (days) 352
Streamway Villa Long stay beds 59/# of patients on waitlist 16/Wait time to placement (days) 215
Warkworth Place Long stay beds 60/# of patients on waitlist 40/Wait time to placement (days) 529
This means in our area of the Central East LHIN, for Basic accommodation, there are 618 beds available (all are full) with 803 people listed as being on a waitlist, waiting to get one of those beds.
In Extendicare Cobourg for example, for Basic Accommodation, this means that nine out of ten people are on average waiting 1585 days to get a bed!
The shortest wait time in the area is for Streamway Villa with just 16 people on the waitlist and a wait time of 215 days. (on average for nine out of ten people).
Of course someone waiting in hospital who is longer able to go home and live independently will be placed in a long term care facility before someone who is wishing to move to a Long-term Care Home and who has low care needs and are managing at home.
It is clear we need more beds made available within Northumberland.
Minimum Standards of Care
Ontario currently has no legislated minimum staff to resident ratio requirement for long-term care facilities.
With current levels of acuity in long- term care and based on the best available evidence, a regulated minimum average of 4 hours of daily hands-on direct care staffing is required to prevent harm and improve outcomes.
Today there are often more tasks to complete than there is staff available to get the tasks done.
Not enough care means residents are fed too quickly, cannot get enough food down, resulting in residents risking dehydration etc. It means little time for bathing or repositioning to prevent sores. It means no friendly visits or socialization for lonely or depressed residents.
As a front line worker reported today at the press conference, even without getting all of the work done , health care workers are still going homes after their shifts, sore and hurt themselves, from the physical energy they have to exert every day.
Author: Pete Fisher
Has been a photojournalist for over 30-years and have been honoured to win numerous awards for photography and writing over the years. Best selling author for the book Highway of Heroes - True Patriot Love
